A pioneering neurosurgeon has successfully removed large brain tumours – some comparable in size to ‘large apples’ – using a refined eyebrow incision technique.
This innovative method, developed by Anastasios Giamouriadis at NHS Grampian in Aberdeen, Scotland, is thought to be the first of its kind globally.
The technique allows for minimal visible scarring and significantly shortens recovery time. Some patients resume daily activities within days.
Mr Giamouriadis has adapted the minimally invasive Modified Eyebrow Keyhole SupraOrbital Approach, enabling access to brain tumours through a small incision above the eyebrow.
Patients wake up immediately post-surgery and sometimes go home within 24 hours, accelerating recovery.
Unlike traditional craniotomies, which involve the removal of a substantial portion of the skull and lengthy recovery periods, this approach minimises exposure to healthy brain tissue.
It reduces total surgery time to around three hours. In comparison, a craniotomy can last eight to ten hours, often requiring up to three hours solely for initial tumour access.
‘The eyebrow method is a game-changer,’ Mr Giamouriadis said, noting the benefit of a much less invasive operation with a smaller scar and reduced risk of complications. I didn’t invent this type of surgery, but I have modified it to give me more space through the eyebrow, and it is allowing me to remove very big brain tumours. We are unaware of anywhere else in the world that has managed to remove tumours as large as we have.’
This modified approach, successfully used on 48 patients, provides ample access to tumours at the front of the brain without extensive cranial opening.
Anastasios Giamouriadis added: ‘We are entering through the eyebrow. It gives us minimal space but allows us to carry out the surgery more quickly and with fewer complications. It’s a game-changer and much less invasive. Traditionally, people would be left with scars across their full forehead; we avoid that with this method. Before we needed do a craniotomy to give us full access. That takes a very long time. To get to the tumour takes up to three hours alone. In total, that approach will take eight to ten hours.’
Doreen Adams (pictured), one of Mr Giamouriadis’s patients, shared her experience, contrasting the eyebrow technique with a previous craniotomy performed abroad.
The 75-year-old said: ‘The recovery after the craniotomy was tough. I contracted sepsis and was ill for a number of weeks, and the recovery took a lot of time. Unfortunately that surgery did not solve the problem and once back in Scotland I was referred to Mr Giamouriadis. For me, the difference between the two surgeries is night and day. My recovery from the surgery at ARI was much, much quicker. I was out of the hospital two days later and almost immediately returned to my normal life. To think you can have brain surgery and be back to normal within a few days is quite incredible.
‘I’m very grateful to Mr Giamouriadis and NHS Grampian – it’s fantastic that we have this innovative approach and these skills here in the north-east.’
Mr Giamouriadis envisions further applications for this technique, potentially using virtual reality to train neurosurgeons globally.
British Neurological Society and the European Association of Neurosurgical Societies have already endorsed it.
